Key result
Adjunctive ticagrelor therapy resulted in rapid clearance of refractory MSSA bacteremia and resolution of thrombocytopenia, supported by in vitro evidence that ticagrelor significantly enhances platelet-mediated killing of S. aureus (P < .001).
Why the study?
Ticagrelor protects against alpha-toxin-mediated platelet injury and thrombocytopenia in mice, motivating evaluation of its clinical utility as adjunctive therapy in human Staphylococcus aureus endovascular infection.
Does ticagrelor improve bacteremia clearance and platelet count in a patient with complicated MSSA bacteremia?
Case Report (n=1)
Does ticagrelor improve bacteremia clearance and platelet count in a patient with complicated MSSA bacteremia?
Ticagrelor may enhance platelet-mediated killing of Staphylococcus aureus, suggesting a potential role as adjunctive therapy for refractory endovascular infections.
Hypothesis-generating for ticagrelor in refractory MSSA bacteremia; prospective trials needed before clinical adoption.
Platelets are a critical immune defense against Staphylococcus aureus bloodstream infections. Staphylococcus aureus α-toxin is a virulence factor that decreases platelet viability and accelerates platelet clearance. It has been shown that ticagrelor blocks α-toxin-mediated platelet injury and resulting thrombocytopenia, protecting mice in a lethal S. aureus sepsis model. We now present the use of ticagrelor as adjunctive therapy in a patient with a S. aureus endovascular infection and thrombocytopenia, associated with restoration of platelet count and bacteremia clearance. Ticagrelor enhanced platelet killing of the S. aureus bloodstream isolate from the treated patient in vitro.
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Ulloa et al. (2021) conducted a case report in Complicated methicillin-susceptible Staphylococcus aureus (MSSA) bacteremia (n=1). Ticagrelor was evaluated on Clearance of bacteremia and in vitro platelet-mediated S. aureus killing (p=<0.001). Adjunctive ticagrelor therapy resulted in rapid clearance of refractory MSSA bacteremia and resolution of thrombocytopenia, supported by in vitro evidence that ticagrelor significantly enhances platelet-mediated killing of S. aureus (P < .001).
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